<form id="add-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Insure_name')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-insure_name" class="form-control" name="row[insure_name]" type="text" data-rule="required">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Damage_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-damage_amount" class="form-control" name="row[damage_amount]" type="text" data-rule="required">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Damage_note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-damage_note" class="form-control" name="row[damage_note]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Other_amount')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-other_amount" class="form-control" name="row[other_amount]" type="text" data-rule="required">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Other_note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-other_note" class="form-control" name="row[other_note]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Parking_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:Form::radios('row[parking_type]', ['1' => '否', '2' => '是'], 1, ['data-rule'=>'required'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Parking_note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-parking_note" class="form-control" name="row[parking_note]" type="text">
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Depreciation_type')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:Form::radios('row[depreciation_type]', ['1' => '否', '2' => '是'], 1, ['data-rule'=>'required'])}
        </div>
    </div>
    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Depreciation_note')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-depreciation_note" class="form-control" name="row[depreciation_note]" type="text">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('Status')}:</label>
        <div class="col-xs-12 col-sm-8">
            {:Form::radios('row[status]', ['1' => '启用', '2' => '禁用'], 1, ['data-rule'=>'required'])}
        </div>
    </div>
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
